| NPI | 1205981453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35089316) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME94982) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2016-09-30 |